News: MedPAC votes out MIPS, recommends alternative payment program

After saying the Merit-based Incentive Payment System (MIPS) was doomed to fall short of its policy goals, the Medicare Payment Advisory Commission (MedPAC) voted in favor of ending the program, according to MedPage Today. The group recommended replacing it with an alternative reimbursement model.

According to MedPAC, the various tracks offered to providers under MIPS—namely, the Medicare Access and CHIP Reauthorization Act (MACRA) and advanced Alternative Payment Models (APM)—have made the program overly complicated.

“Our most basic concern is that the measures in MIPS have not been proven to be associated with high-value care,” David Glass, a principal policy analyst for MedPAC told MedPage Today.

The alternative proposed (titled the Voluntary Value Program) would get rid of the MIPS program and all three types of reporting it required and also do away with CMS’ support for EHR reporting, according to MedPage Today.

The new model would withhold a certain (undetermined) percentage of clinicians’ fee schedule dollars. That money would then be lumped into a pool. Clinicians would then have three options:

• Choose to be measured with a “sufficiently large entity” of clinicians (those affiliated with a single hospital or a geographic area) and be eligible for value payments
• Choose to participate in an Advanced APM
• Lose the withheld fee schedule dollars

The measures in the Voluntary Value Program could potentially fall under three categories: clinical quality, patient experience, and value.

Though the MedPAC voted 14-2 to do away with MIPS, there were still some misgivings and hesitation among the MedPAC members. Most of the apprehension came from the uncertainty inherent in the new Voluntary Value Program.

But, Commissioner Dana Gelb Safran, ScD, of Blue Cross Blue Shield of Massachusetts in Boston, pointed out, “I don’t hear a single commissioner saying we must preserve MIPS.”

Editor’s note: To read the full coverage of the vote from MedPage Today, click here. To read about the proposed Voluntary Value Program, click here. To read about MedPAC’s criticism of MIPS in October, click here.